MyMedR

Intraoperative methylene blue sentinel lymph node mapping in colorectal cancer

Chan SH, Ng C, Looi LM

ANZ J Surg, 2008 Sep;78(9):775-9.

PMID: 18844907 DOI: 10.1111/j.1445-2197.2008.04648.x

Isosulfan blue is not available for clinical use in Malaysia. This study describes the use of methylene blue as an alternative to isosulfan blue in colorectal sentinel node mapping.

Matched MeSH terms: Aged, 80 and over

The views of older Malaysians on advanced directive and advanced care planning: a qualitative study

Htut Y, Shahrul K, Poi PJ

Asia Pac J Public Health, 2007;19(3):58-67.

PMID: 18330404

The provision of optimum care for the ageing population is dependent on the understanding of their views and values on end of life issues. A qualitative descriptive study was conducted to describe views of elderly Malaysians on Advanced Care Planning (henceforth ACP) and Advanced Directives (henceforth AD), and explore factors influencing these views. Fifteen elderly subjects with ages ranging from 65 to 83 years, representing different ethnic and religious groups in Malaysia were selected for in-depth interviews guided by a questionnaire. Five core themes were extracted from the interviews: 1) Considering the future 2) Contingency plans for future illnesses 3) Attitudes towards life prolonging treatment procedures 4) Doctor-patient relationships and 5) Influence of religion on decisions related to future illness. Despite the lack of knowledge on ACP and AD, older respondents were very receptive to their concept. Although the majority agreed on the importance of planning for future medical management and having open discussion on end of life issues with their doctor, they felt it unnecessary to make a formal written AD. Most felt that the future was best left to fate or God, and none had made any contingency plan for severe future illnesses citing religion as reason for this view. Cardiopulmonary resuscitation, mechanical ventilation and dialysis were considered by most to be invasive life prolonging treatments. We suggest that doctors initiate discussions on end of life care with every older patient and their family so as to promote awareness and introduce the concept of ACP/AD to a Malaysian setting.

Matched MeSH terms: Aged, 80 and over

Effect of haemodialysis on intraocular pressure

Samsudin A, Mimiwati Z, Soong T, Fauzi MS, Zabri K

Eye (Lond), 2010 Jan;24(1):70-3.

PMID: 19229270 DOI: 10.1038/eye.2009.33

To study the effect of haemodialysis on intraocular pressure (IOP) of patients at the University Malaya Medical Centre, Kuala Lumpur, and the influence of anterior chamber angles, surgery, and diabetes on the change in IOP after haemodialysis.

Matched MeSH terms: Aged, 80 and over

Combined large radial retinotomy and circumferential retinectomy in the management of advanced proliferative vitreoretinopathy

Lim AK, Alexander SM, Lim KS

Retina, 2009 Jan;29(1):112-6.

PMID: 18784619 DOI: 10.1097/IAE.0b013e318187f14a

Matched MeSH terms: Aged, 80 and over

Fulltext Two years review of cutaneous adverse drug reaction from first line anti-tuberculous drugs

Tan WC, Ong CK, Kang SC, Razak MA

Med J Malaysia, 2007 Jun;62(2):143-6.

PMID: 18705448 MyJurnal

First line Anti-TB therapy with rifampicin, isoniazid, pyrazinamide, and ethambutol/streptomycin is very effective. However, major adverse reactions to antituberculous drugs can cause significant morbidity and mortality. Cutaneous adverse drug reaction (CADR) is one of the commonly observed major adverse events. This retrospective study looked at the cases of TB treated in Respiratory Unit, Penang Hospital from January 2004 to December 2005. Of 820 patients treated for active TB, 47 patients (25 females; 22 males) developed CADR (5.7%). CADRs observed include morbiliform rash (72.3%), erythema multiforme syndrome (8.5%), urticaria (8.5%) and others (which include exfoliative dermatitis and lichenoid eruption). Ninety-seven percent of events occurred within two months after the initial dose. Incidence rate of CADR among the first line anti-TB drugs, pyrazinamide was the commonest offending drug (2.38%), followed by streptomycin (1.45%), ethambutol (1.44%), rifampicin (1.23%) and isoniazid (0.98%). Various clinical characteristics of patients with CADR identified include Human Immunodeficiency Virus (HIV) infection (27.7%), polypharmacy (21.3%), elderly (19.1%), autoimmune disorders (6.4%), pre-existing renal impairment (4.3%), pre-existing liver disorders (4.3%). In conclusion, CADR is common and majority of cases occurred within two months after initiation of anti-TB treatment, particularly in HIV infected patients. Pyrazinamide is the commonest offending drug.

Matched MeSH terms: Aged, 80 and over

Fulltext Underutilization of angiotensin converting enzyme inhibitors among heart failure patients

Lean QY, Shamsuddin N, Wan Ahmad WA

Med J Malaysia, 2008 Aug;63(3):216-21.

PMID: 19248693 MyJurnal

There are well-established guidelines regarding the use of Angiotensin converting enzyme inhibitors (ACEI) in the management of heart failure (HF). In-spite of that, many studies has documented underutilization of ACEI. Thus, this retrospective observational study aimed to evaluate the utilization of ACEI, to identify the pattern of ACEI use and the factors that might contribute to underutilization of ACEI. The target population was hospitalized HF patients in University Malaya Medical Centre (UMMC). Of 321 hospitalized HF patients, only 57% of them were treated with ACEI. 51.2% of the patients treated with ACEI received low dose (< or = 25% from target dose) at discharge. Factors that have significant association with the underutilization of ACEI included serum potassium and creatinine, chronic renal failure and other concurrent medications used (frusemide, aspirin, potassium chloride, calcium channel blockers and angiotensin receptor blockers). The findings indicated that the utilization of ACEI in the management of HF in UMMC is considerably low.

Matched MeSH terms: Aged, 80 and over

Fulltext The TB--Crohn's affair--a never ending dilemma

Praveen S, Razman J

Med J Malaysia, 2008 Aug;63(3):259-60.

PMID: 19248705

An 80 year old lady presented with signs and symptoms of sub-acute intestinal obstruction which failed conservative management. CT scan abdomen revealed circumferential ileum thickening with proximal bowel dilatation. Laparotomy and segmental resection was done. Pathological findings were suggestive of chronic granulomatous ileits with differential of Crohn's disease and gastrointestinal tuberculosis. The patient was presumed to have gastrointestinal tuberculosis and commenced on anti tuberculosis treatment despite inconclusive evidence for confirmation and showed marked clinical improvement.

Matched MeSH terms: Aged, 80 and over

Perceived vaccination status in ecotourists and risks of anthropozoonoses

Muehlenbein MP, Martinez LA, Lemke AA, Ambu L, Nathan S, Alsisto S, et al.

Ecohealth, 2008 Sep;5(3):371-8.

PMID: 18810550 DOI: 10.1007/s10393-008-0192-y

Anthropozoonotic (human to nonhuman animal) transmission of infectious disease poses a significant threat to wildlife. A large proportion of travelers to tropical regions are not protected against vaccine-preventable illnesses, and a majority of these travelers demonstrate poor recall of actual vaccination status. Here we characterize self-perceived vaccination status among a large sample of ecotourists at the Sepilok Orangutan Rehabilitation Centre, Sabah, Malaysia. Despite their recognized travel itinerary to view endangered animals, tourists at wildlife sanctuaries are not adequately protected against vaccine-preventable illnesses. Of 633 surveys, over half reported being currently vaccinated against tuberculosis, hepatitis A, hepatitis B, polio, and measles. Fewer participants reported current vaccination status for influenza, rabies, and chickenpox. Despite the fact that the majority of visitors to Sepilok are from temperate regions where influenza is relatively more prevalent, 67.1% of those surveyed with medical-related occupations reported not being currently vaccinated for influenza. Ecotourists concerned about environmental protection are themselves largely unaware of their potential contribution to the spread of diseases to animals. The risks of negatively affecting animal populations must be communicated to all concerned parties, and this may begin by urging travelers to examine their actual vaccination status, particularly as the ecotourism industry continues its rapid expansion, and is seen increasingly as a possible tool to save great ape populations from extinction.

Matched MeSH terms: Aged, 80 and over

Prevalence of pseudoexfoliation in Malay population in Singapore

Sumasri K, Raju P, Aung T, Tin A, Wong TY

Am J Ophthalmol, 2008 Apr;145(4):766-7; author reply 767.

PMID: 18358854 DOI: 10.1016/j.ajo.2007.12.028

Matched MeSH terms: Aged, 80 and over

How well were asthmatic patients educated about their asthma? A study at the emergency department

Lee PY, Khoo EM

Asia Pac J Public Health, 2004;16(1):45-9.

PMID: 18839867 DOI: 10.1177/101053950401600108

70 patients presented with acute asthma exacerbation requiring nebulised bronchodilator treatment at the emergency department of a teaching hospital in Kuala Lumpur, Malaysia, were interviewed over a two-week period in July 2001. The results showed that 45 (64%) patients had not been educated on the nature of asthma; 30 (43%) had not been advised on preventive measures or avoidance of triggers; 54 (77%) were not advised about the medications used and their side effects; 42 (60%) patients did not know the difference between reliever and preventive medications; 37 (53%) were unable to recognize features of worsening asthma and 68 (97%) were not told about the danger of non-prescribed self-medication or traditional medications. Only six (9%) patients were using peak flow meters and were taught self-management plans. The multiple regression results suggest that patients who were followed up at teaching hospital based clinics were better educated on asthma. In conclusion, asthmatic patients are still not educated well about their disease. Health care providers need to put more emphasis on asthma education so that the number of emergency room visits can be reduced.
Study site: Emergency department, University Malaya Medical Centre, Kuala Lumpur, Malaysia

Matched MeSH terms: Aged, 80 and over

Fulltext Prevalence of undetected cognitive impairment and depression in residents of an elderly care home

Al-Jawad M, Rashid AK, Narayan KA

Med J Malaysia, 2007 Dec;62(5):375-9.

PMID: 18705469 MyJurnal

The elderly population in Malaysia is growing rapidly. Some of the most vulnerable are in residential care. Research is needed into the characteristics of this population to aid clinicians and policy makers in addressing the needs of this group. This observational, cross-sectional study aims to determine prevalence of undetected cognitive impairment and depression in elderly care home residents in Malaysia. One hundred and sixty-seven people over 60 years of age living in a state run residential home were interviewed. Validated assessment tools were used to measure dependency, cognitive impairment and depression. The prevalence of probable dementia is 36.5%, with increasing prevalence with age and level of dependence. Prevalence of depression is 67.0% (major depression 13.2%), with more depression in males and in the Indian population. None of the identified cases had been previously investigated or treated for dementia or depression.

Matched MeSH terms: Aged, 80 and over

Fulltext Dropped nucleus following phacoemulsification cataract surgery

Tajunisah I, Reddy SC

Med J Malaysia, 2007 Dec;62(5):364-7.

PMID: 18705466 MyJurnal

Twenty two cases of dropped nucleus following 1,196 phacoemulsification procedures in cataract surgery were examined retrospectively to determine the incidence, predisposing factors and visual outcomes of this dreaded complication. All the cases underwent pars plana vitrectomy and the lens fragments were removed with phacofragmotome, vitrectomy cutter or delivered through limbus. The incidence of dropped nucleus was 1.84%. The predisposing factors were hard cataracts (13.6%), polar cataracts (9.1%), previously vitrectomized eyes (4.5%) and high myopia (4.5%). The final visual outcome was > or = 6/12 in 10 eyes (45.5%); complications were seen in 5 eyes (22.7%). The interval between initial surgery and vitrectomy, the method of fragment removal and the type of lens implanted, did not influence the final visual outcome.

Matched MeSH terms: Aged, 80 and over

Further evidence of ethnic and gender differences for Helicobacter pylori infection among endoscoped patients

Sasidharan S, Uyub AM, Azlan AA

Trans R Soc Trop Med Hyg, 2008 Dec;102(12):1226-32.

PMID: 18586289 DOI: 10.1016/j.trstmh.2008.05.006

HeIicobacter pylori infection rate was determined in 697 consecutive patients with ulcer, gastritis, duodenitis and non-ulcer dyspepsia by endoscopy at a Malaysian hospital in 1999-2002. Biopsies of the gastric antrum and body were subjected to the urease test, Gram staining of impression smears and culture examination. Infection was defined as a positive result in at least one test. The infection rates were 32.1, 10.4, 20.0 and 16.2% in ulcer, gastritis, duodenitis and non-ulcer dyspepsia patients, respectively. Overall, the prevalence of H. pylori infection was 14.6%, with the rate among the Indian (21.7%), Chinese (19.2%) and Bangladeshi foreign worker (23.1%) groups significantly higher (P<0.05) than that of the Malays (5.8%). Generally, the prevalence rate among males (18.9%) was significantly higher (P<0.001) than that among females (9.0%), but for a particular ethnic group, such trend and significant differences (P<0.05) were observed only among the Malays. In terms of gender, the prevalence rates of Malay males and females were also significantly lower (P<0.05) than those of Chinese and Indians. In conclusion, there is a significant difference in H. pylori infection prevalence rates among ethnic groups (highest in Indians, then Chinese and unusually low in Malays) and gender groups (highest in males) in Malaysia.

Matched MeSH terms: Aged, 80 and over

Outcome of patients with head and neck cancers: 10-year experience of a otorhinolaryngology--head and neck unit in a tertiary hospital of a developing country

Shashinder S, Choo PK, Gopala KG

Eur J Cancer Care (Engl), 2008 Jan;17(1):93-7.

PMID: 18181897 DOI: 10.1111/j.1365-2354.2007.00814.x

Being a rapidly developing country, a study was needed to see how we faired in treating head and neck cancer patients compared with international standards. Although being a retrospective study, this research shows that there is still a lot to be done in our developing nation in educating the general public about head and neck cancers as most of them presented in the later stages to us. There also needs to be a proper review about the treatment modality offered to patient as our survival results are far behind in certain categories of cancers compared with the developed nations.

Matched MeSH terms: Aged, 80 and over

Fulltext Acute renal failure in the same hospital ten years apart

Chow YW, Lim BB, Hooi LS

Med J Malaysia, 2007 Mar;62(1):27-32.

PMID: 17682566 MyJurnal

A three month prospective study was carried out in 1994 (8/3/94 - 7/6/94) and late 2004/early 2005 (24/11/2004 - 15/2/2005) among patients with acute renal failure (ARF) (serum creatinine > 0.200 mmol/1). Incidence of ARF had increased from 0.48% (78/16,418) to 1.1% (211/18,697) of admissions between 1994 and 2004. Two thirds of patients were male. Mean age was 57.7 +/- 20.1 years in 1994 and 55.6 +/- 17.8 years in 2004. No difference was noted in causative factors, rate of oliguric ARF (about 10%) and mean peak urea and creatinine. The cause was pre-renal failure in 43.6% in 1994 and 53.5% in 2004. The second commonest cause was sepsis with 41% in 1994 and 37.9% in 2004. One in six patients needed dialysis and peritoneal dialysis was the main dialysis modality (69.2% and 74.3%). Mortality was 56.4% in 1994 and 44.5% in 2004. A quarter of deaths occurred within two days of admission due to severe underlying illness. Mortality among non-oliguric patients decreased from 52.9% in 1994 to 37.0% in 2004 (p = 0.04); for patients from intensive care units it was 78.3% in 1994 and 68.5% in 2004.

Matched MeSH terms: Aged, 80 and over

Fulltext The risk factors of gastrointestinal bleeding in acute ischaemic stroke

Hamidon BB, Raymond AA

Med J Malaysia, 2006 Aug;61(3):288-91.

PMID: 17240577 MyJurnal

Gastrointestinal (GI) bleeding is one of the most serious complications after an acute ischaemic stroke and may affect stroke outcome. We identified predictors and the eventual outcome of gastrointestinal bleeding during the in-patient period following the commencement of aspirin. This was a study of patients with acute ischaemic stroke admitted to Universiti Kebangsaan Malaysia Hospital from June 2000 to January 2001. A single observer, using predefined diagnostic criteria recorded information on demography, risk factors and GI bleeding that occurred during the inpatient period. One hundred and fifteen patients with acute ischaemic stroke were enrolled in the study. Gastrointestinal bleeding was observed in 6 (5.2%) patients. Using univariate analysis, the independent predictors of gastrointestinal bleeding were age (OR 1.25; 95% CI 1.07 to 1.50), and middle cerebral artery (MCA) territory infarcts (OR 9.47; 95% CI 1.62 to 55.5). Using multivariate analysis, the presence of gastrointestinal bleeding increased mortality (OR 24.97; 95% CI 1.97 to 316.91). Older age, and large MCA infarct predict the development gastrointestinal bleeding. Stroke mortality was independently predicted by gastrointestinal bleeding. Prophylactic treatment in elderly patients with large cerebral infarcts may be an area for further investigation.

Matched MeSH terms: Aged, 80 and over

The relationship between socioeconomic deprivation, atypical respiratory infections and survival outcome in elderly stroke and medical patients

Ngeh J, Hackshaw A, Gupta S

Cerebrovasc Dis, 2007;24(6):546-7.

PMID: 18042982

Matched MeSH terms: Aged, 80 and over

Specimen shrinkage and its influence on margin assessment in breast cancer

Yeap BH, Muniandy S, Lee SK, Sabaratnam S, Singh M

Asian J Surg, 2007 Jul;30(3):183-7.

PMID: 17638637

The determination of tumour-free margin in breast cancer is crucial in deciding subsequent patient management. To exemplify the phenomenon of margin contraction during specimen preparation for histopathological analysis, we quantified the shrinkage of breast specimens as a result of formalin fixation.

Matched MeSH terms: Aged, 80 and over

Fulltext The transcolumellar transsphenoidal approach to pituitary tumours: advantanges and limitations

Gendeh BS, Sakina MS, Selladurai BM, Jegan T, Misiran K

Med J Malaysia, 2006 Aug;61(3):349-54.

PMID: 17240588

A retrospective review was performed on 11 patients who had undergone the transcolumellar transsphenoidal hypophysectomy in our center. There were eight females and three males with age ranging from 17 to 72 years (mean 50 years). Ten patients had pituitary macroadenomas and one had suprasellar cyst. The mean follow up duration for these 11 patients post surgery was 7.2 months. Complications included two cerebrospinal leaks, one postoperative sphenopalatine bleed, one septal perforation and one patient developed numbness of the tip of the nose. We found that this approach is a preferred alternative technique especially in smaller Oriental noses with lower complication rate and better aesthetic result.

Matched MeSH terms: Aged, 80 and over

Benign parotid lesions: is near total parotidectomy justified?

Arshad AR

Ann Acad Med Singap, 2006 Dec;35(12):889-91.

PMID: 17219001

INTRODUCTION: Benign tumours of the parotid gland constitute about 80% of parotid tumours. The most common benign tumour of the parotid gland is pleomorphic adenoma. Other conditions, like Kimura's disease, may mimic a tumour when they present as a parotid mass. Various modes of treatment have been advocated for the treatment of benign parotid lesions, ranging from enucleation to near-total parotidectomy.

MATERIAL AND METHODS: This is an audit of an 18-year period where 173 lesions of the parotid gland (34 malignant and 139 benign lesions) were treated by the author.

RESULTS: There were 139 benign lesions, of which 123 were benign tumours and 16 non-tumour conditions. Fourteen cases of recurrent pleomorphic adenoma of parotid that had been treated elsewhere were also operated on. Near-total parotidectomy was performed on all these cases with benign lesions.

CONCLUSIONS: There has been no recurrence in all the patients who was treated this way. Near-total parotidectomy should be considered when there is a need to treat benign parotid swellings.

Matched MeSH terms: Aged, 80 and over

Displaying publications 301 - 320 of 1997 in total